Determinants of Intima-Media Thickness in the Young

Chiesa, Scott T; Charakida, Marietta; Georgiopoulos, Georgios; Dangardt, Frida; Wade, Kaitlin H; Rapala, Alicja; Bhowruth, Devina; Nguyen, Helen; Muthurangu, Vivek; Shroff, Rukshana; Smith, George Davey; Lawlor, Debbie A.; Sattar, Naveed; Timpson, Nicholas J.; Hughes, Alun D.; Deanfield, John

doi:10.1016/j.jcmg.2019.08.026

Cited by 53 publications

(107 citation statements)

References 29 publications

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“…Corresponding, a significantly higher tensile stress was found in obese and overweight girls and boys in this study population. Similar results were made by Chiesa et al [29], who described an increased lumen, but a lower IMT with a reduced IDR and an increased tensile stress in obese young study participants. These findings indicate that risk factors for CVD, such as obesity, may be better explained by referring to IDR than IMT alone.…”

Section: Discussionsupporting

confidence: 89%

“…Regarding the values of this healthy study population, a constant IDR over childhood can be assumed. In concordance, Chiesa et al [29] suggested that increased fat-free mass is the predominant factor leading to a thickened IMT. In a growth-associated physiologic process, D increases as well-IDR, thereby, is kept at a constant level.…”

Section: Discussionmentioning

confidence: 64%

“…This study provides age-and sex-dependent values for D, IDR, and tensile stress of the CCA for a sample of 642 healthy, non- [40]. Nevertheless, conflicting results do exist due to methodological and population differences [22,29,[40][41][42][43].…”

Section: Discussionmentioning

confidence: 99%

“…Because adaptations of IMT and D may not always occur simultaneously, monitoring both parameters and measuring their ratio, defined as IDR, can offer a more differentiated view of vascular changes. These parameters may indicate whether IMT and D adapt in terms of adequate remodeling or within a pathologic process [28,29]. In contrast to IMT, for which reference values exist [30][31][32], there are no reference values for D and IDR in children.…”

Section: Introductionmentioning

confidence: 99%

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Vascular diameter and intima-media thickness to diameter ratio values of the carotid artery in 642 healthy children

et al. 2020

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In children, arterial alterations occur with increased intima-media thickness as well as vascular diameter enlargement. Both conditions correlate with higher cardiovascular risk in adults, and both the array and proportion of these alterations are important hemodynamic parameters. In terms of functional adaptation processes, they influence several arterial wall properties as for example the shear and tensile stress of the vessel. There are no reference values for the vascular diameter and intima-media thickness/diameter ratio of the carotid artery in children. Therefore, this study aimed to assess vascular diameter, intima-media thickness/diameter ratio and related tensile stress values in children and to further investigate the influence of sex, age, body mass index, and blood pressure. The parameters were measured with high-resolution semi-automated ultrasound. Sex- and age-dependent values were calculated with the LMS method for a cross-sectional sample of 642 healthy, non-obese children aged 8–17 years. The mean vascular diameter was 5.45 ± 0.46 mm; the median intima-media thickness/diameter ratio was 0.085 (0.079–0.092); the median tensile stress was 105.4 (95.2–116.4) kPa. The vascular diameter and the tensile stress were higher, and the intima-media thickness/diameter ratio was lower in boys than in girls. In comparison to the normal weight study population the excludedobese children had a significantly higher diameter, a lower intima-media thickness/diameter ratio, and a higher tensile stress. In multiple regression analyses of diameter, intima-media thickness/diameter ratio, and tensile stress, all parameters were influenced by sex and body mass index. Furthermore, systolic and diastolic blood pressure significantly influenced the vascular diameter, and systolic blood pressure significantly influenced the intima-media thickness/diameter ratio. Conclusion: This study is the first to report values for the diameter, the intima-media thickness/diameter ratio of the carotid artery, and the related tensile stress allowing a more differentiated view of cardiovascular adaptations as it combines structural and functional vascular parameters. What is known:• Intima-media thickness and vascular diameter are related to a higher cardiovascular risk in adults• The intima-media thickness/diameter ratio gives information about hemodynamic and functional vessel adaptationWhat is new:• Values for vascular diameter, intima-media thickness/diameter ratio, and tensile stress of the carotid artery in children are presented in this study• Intima-media thickness as a surrogate marker for arterial health in children should be complemented by intima-media thickness/diameter ratio measurement

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Vascular diameter and intima-media thickness to diameter ratio values of the carotid artery in 642 healthy children

et al. 2020

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“…Unexpectedly, we found CRP in ALSPAC to in fact be negatively associated with a number of risk factors in fully-adjusted models, and was therefore associated with a decreased risk of MetS during follow-up. The reasons for this are unclear, but are similar to previous findings in this same cohort where CRP has shown some evidence of a negative relationship to carotid intima-media thickness -a commonly-used marker of subclinical atherosclerosis (30).…”

Section: Discussionsupporting

confidence: 81%

Elevated glycoprotein acetyl levels in adolescence and early adulthood predict adverse cardiometabolic profiles and risk of metabolic syndrome in up to 10 year follow-up

Chiesa

Charakida

Georgiopoulos

et al. 2020

Preprint

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Objective: Low-grade inflammation in the young may contribute to the early development of adverse cardiometabolic risk profiles. We assessed whether measures of glycoprotein acetylation (GlycA) were better able to detect the development of these changes compared to the more commonly used biomarker high-sensitivity C-reactive protein (CRP), and investigated whether these relationships differed in an adolescent compared to young adult cohort. Research Design and Methods: A total of 3306 adolescents (Avon Longitudinal Study of Parents and Children - ALSPAC; mean age 15.4 ± 0.3; n=1750) and young adults (Cardiovascular Risk in Young Finns Study - YFS; mean age 32.1 ± 5.0; n=1556) were included. Inflammatory biomarkers (GlycA/CRP), body composition (BMI / waist circumference) and cardiometabolic risk factors (blood pressure, triglycerides, HDL-c, glucose, insulin, and homeostasis model of insulin resistance [HOMA_IR]), were measured at baseline and again in 9-10 year follow-up. Metabolic Syndrome (MetS) was defined using adolescent-specific National Cholesterol Education Programme (NCEP) guidelines in ALSPAC and standard NCEP guidelines in YFS. Results: GlycA levels showed greater within-subject correlation over the 9-10 year duration of follow-up in both cohorts when compared to CRP, particularly in the younger adolescent group. In adjusted models, only GlycA was found to increase in line with cardiometabolic risk factor burden at baseline, and to predict adverse changes in several cardiometabolic risk factors in follow-up. In both cohorts, GlycA predicted future risk of MetS (OR [95%CI] for Q4 vs. Q1 = 1.95 [1.08,3.53] and 2.74 [1.30,5.73] for ALSPAC and YFS, respectively), whereas CRP showed a neutral or even negative relationship in fully-adjusted models (OR [95%CI] = 0.50 [0.29,0.86] and 0.93 [0.53,1.64]). Conclusions: Chronic inflammation is associated with adverse cardiometabolic risk profiles from as early as adolescence and predicts risk of future cardiometabolic risk and MetS in up to 10 year follow-up. GlycA may be a more sensitive inflammatory biomarker to CRP for detecting early cardiometabolic and cardiovascular risk in the young.

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Early-Life Risk Factors for Carotid Intima-Media Thickness and Carotid Stiffness in Adolescence

van der Linden,

Roodenburg,

Nijhof

et al. 2024

JAMA Netw Open

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ImportanceAtherogenesis starts during childhood, making childhood and adolescence an important window of opportunity to prevent atherosclerotic cardiovascular disease later in life.ObjectiveTo identify early-life risk factors for preclinical atherosclerosis in adolescence.Design, Setting, and ParticipantsThis cohort study is part of the ongoing Wheezing Illness Study in Leidsche Rijn (WHISTLER) prospective birth cohort study, which includes 3005 healthy newborns born between December 2001 and December 2012 in the Leidsche Rijn area of Utrecht, the Netherlands. Eligible participants included those from the WHISTLER cohort who visited the clinic between March 2019 and October 2020 for adolescent follow-up. This study’s analyses were performed in January 2024.ExposuresEarly-life growth was assessed at birth to 6 months, 5 years, and 12 to 16 years. Abdominal ultrasonography determined abdominal subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) depth. Blood pressure (BP) percentiles and body mass index (BMI) z scores were used.Main Outcomes and MeasuresCarotid ultrasonography was performed at age 12 to 16 years to assess carotid intima-media thickness (cIMT) and the distensibility coefficient (DC), established measures of preclinical atherosclerosis. Multivariable linear regression models were used to identify early-life risk factors for cIMT and DC in adolescence.ResultsIn total, 232 adolescents (median [IQR] age, 14.9 [13.7-15.8] years; 121 female [52.2%]) were included. More postnatal weight gain (B = 12.34; 95% CI, 2.39 to 22.39), higher systolic BP at 5 years (B = 0.52; 95% CI, 0.02 to 1.01), more VAT at 5 years (B = 3.48; 95% CI, 1.55 to 5.40), and a larger change in VAT between 5 and 12 to 16 years (B = 3.13; 95% CI, 1.87 to 4.39) were associated with a higher cIMT in adolescence. A higher BMI (B = −2.70, 95% CI,−4.59 to −0.80) and VAT at 5 years (B = −0.56; 95% CI, −0.87 to −0.25), as well as a larger change in BMI between 5 and 12 to 16 years (B = −3.63; 95% CI, −5.66 to −1.60) were associated with a higher carotid stiffness in adolescence. On the contrary, a larger change in SAT between 5 and 12 to 16 years (B = 0.37; 95% CI, 0.16 to 0.58) was associated with a higher carotid DC in adolescence.Conclusions and RelevanceIn this cohort study of 232 participants, early-life growth parameters, and particularly abdominal VAT development, were associated with a higher cIMT and carotid stiffness in adolescence. These findings suggest that assessment of adipose tissue development during childhood can aid characterization of lifetime risk trajectories and tailoring of cardiovascular prevention and risk management strategies.

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Determinants of Intima-Media Thickness in the Young

Cited by 53 publications

References 29 publications

Vascular diameter and intima-media thickness to diameter ratio values of the carotid artery in 642 healthy children

Vascular diameter and intima-media thickness to diameter ratio values of the carotid artery in 642 healthy children

Elevated glycoprotein acetyl levels in adolescence and early adulthood predict adverse cardiometabolic profiles and risk of metabolic syndrome in up to 10 year follow-up

Early-Life Risk Factors for Carotid Intima-Media Thickness and Carotid Stiffness in Adolescence

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